Perindopril: Clinical profile of a unique ACE inhibitor

There are 3 major reasons to seek better antihypertensive agents: hypertens ion is often untreated, undertreated, or poorly controlled; therapy has not been successful in reducing the incidence of coronary artery disease; and hypertension is not simply a matter of high blood pressure per se, but is p art of a complex inherited syndrome of cardiovascular risk factors that inc lude decreased arterial compliance. It is estimated that blood pressure is adequately controlled in only one qu arter of the 43 million Americans with hypertension. Both lack of patient a dherence to therapy and physicians' failure to treat hypertension early and aggressively contribute to poor blood pressure control. Given this poor tr ack record in controlling blood pressure and the multifactorial nature of h ypertension, there is a growing need for new agents that are effective, sim ple to use, well tolerated, and formulated for once-a-day dosing. Angiotens in-converting enzyme (ACE) inhibitors and angiotensin receptor blockers are useful in this regard because they block both the renin-angiotensin and br adycardic systems. People at risk far developing hypertension-particularly those with a family history of the disease-should be identified early and managed appropriatel y because they tend to develop abnormalities that adversely affect endothel ial structure and function long before they develop high blood pressure.